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Latest & greatest articles for antibiotics
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Antibiotics also referred to as antibacterial are a type of medicine that prevents the growth of bacteria. As such they are used to treat infections caused by bacteria. They kill or prevents bacteria from spreading.
Antibiotics are vital in modern day medicine; they are among the most frequently prescribed drug. There are over a 100 types of antibiotics, the main types and most commonly prescribed are penicillin, cephalosporin, macrolides, fluoroquinolone and tetracycline. They tend to be classified by mechanism of action. So, those that target the bacterial cell wall (penicillins and cephalosporins) or the cell membrane (polymyxins), or interfere with essential bacterial enzymes (rifamycins, lipiarmycins, quinolones, and sulfonamides) have bactericidal activities. Antibiotics such as macrolides, lincosamides and tetracyclines inhibit protein synthesis.
Antibiotics can all be defined by their specificity. “Narrow-spectrum” antibiotics target specific types of bacteria, for instance gram-negative (-ve) or gram-positive (+ve), whereas broad-spectrum antibiotics affect a wide range of bacteria.
Antibiotics are increasingly suffering from antibiotic resistance caused by bacterial mutations meaning the bacteria evolves to not be sensitive to the specific antibiotics being used.
Clinical trials are important to the development and understanding of antibiotics and their side effects. Although they are deemed safe, over use of the drug can kill good bacteria and lead to antibiotic resistance. This halts the ability of bacteria and microorganisms to resist the effects of the antibiotic. Clinical trials and research allow scientists and medical professionals to study the effects and develop new antibiotics.
Tools for GPs can help reduce unnecessary antibiotic prescribing Tools for GPs can help reduce unnecessary antibiotic prescribing Dissemination Centre Discover Portal NIHR DC Discover Tools for GPs can help reduce unnecessary antibiotic prescribing Published on 30 October 2018 doi: Interventions to reduce inappropriate antibiotic prescribing for upper respiratory tract infections are most effective when they provide a negotiation tool to support patient interaction. These interventions are more (...) likely to be rejected if they are perceived as interfering with individual clinical judgment or damaging patient relationships. Upper respiratory tract infections often resolve themselves within a few days, without the need for antibiotics, yet antibiotics are often prescribed. This systematic review of qualitative studies explored what primary care professionals who prescribe thought about interventions designed to reduce antibiotic prescribing for acute respiratory infections. These findings
Antibiotic allergy. Antibiotics are the commonest cause of life-threatening immune-mediated drug reactions that are considered off-target, including anaphylaxis, and organ-specific and severe cutaneous adverse reactions. However, many antibiotic reactions documented as allergies were unknown or not remembered by the patient, cutaneous reactions unrelated to drug hypersensitivity, drug-infection interactions, or drug intolerances. Although such reactions pose negligible risk to patients (...) , they currently represent a global threat to public health. Antibiotic allergy labels result in displacement of first-line therapies for antibiotic prophylaxis and treatment. A penicillin allergy label, in particular, is associated with increased use of broad-spectrum and non-β-lactam antibiotics, which results in increased adverse events and antibiotic resistance. Most patients labelled as allergic to penicillins are not allergic when appropriately stratified for risk, tested, and re-challenged. Given
Shared decision making in primary care can reduce antibiotic prescribing Signal - Shared decision making in primary care can reduce antibiotic prescribing Dissemination Centre Discover Portal NIHR DC Discover Shared decision making in primary care can reduce antibiotic prescribing Published on 26 January 2016 Strategies, known as shared decision making, reduced antibiotic prescribing for people with acute respiratory infections by almost 40% in the short term (up to six weeks). This Cochrane (...) in this review were from the UK and the other six were from high-income European countries and Canada, so the findings are applicable to the UK. There is insufficient evidence about the long term effect (up to one year and beyond) of the strategies used to facilitate shared decision making, so it is not known whether they could reverse community-level antibiotic resistance trends. It is likely that multiple approaches will be needed. Share your views on the research. Why was this study needed? Antibiotic
Triple Antibiotic Solution Promotes Similar Antibacterial Effects as Calcium Hydroxide/2% Chlorhexidine When Used as an Intracanal Medicament UTCAT3361, Found CAT view, CRITICALLY APPRAISED TOPICs University: | | ORAL HEALTH EVIDENCE-BASED PRACTICE PROGRAM View the CAT / Title Triple Antibiotic Solution Promotes Similar Antibacterial Effects as Calcium Hydroxide/2% Chlorhexidine When Used as an Intracanal Medicament Clinical Question In patients undergoing non-surgical therapy in a tooth (...) diagnosed with pulpal necrosis, does the use of triple antibiotic paste as an intracanal medicament have better antibacterial efficacy than a calcium hydroxide/chlorhexidine formulation? Clinical Bottom Line Triple antibiotic solution (1 mg/mL) promoted similar antibacterial effects as calcium hydroxide/2% chlorhexidine when used as an intracanal medicament. This is based on several randomized clinical trials in which intracanal medicaments were placed for 7 to 21 days in primary and immature/mature
A systematic review of local antibiotic devices used to improve wound healing following the surgical management of foot infections in diabetics 30418057 2018 11 26 2018 12 02 2049-4408 100-B 11 2018 Nov The bone & joint journal Bone Joint J A systematic review of local antibiotic devices used to improve wound healing following the surgical management of foot infections in diabetics. 1409-1415 10.1302/0301-620X.100B11.BJJ-2018-0720 Local antibiotics are used in the surgical management of foot (...) infection in diabetic patients. This systematic review analyzes the available evidence of the use of local antibiotic delivery systems as an adjunct to surgery. Databases were searched to identify eligible studies and 13 were identified for inclusion. Overall, the quality of the studies was poor. A single trial suggested that wound healing is quicker when a gentamicin-impregnated collagen sponge was implanted at time of surgery, with no difference in length of stay or rate of amputation. Results from
Advances in optimizing the prescription of antibiotics in outpatient settings. The inappropriate use of antibiotics can increase the likelihood of antibiotic resistance and adverse events. In the United States, nearly a third of antibiotic prescriptions in outpatient settings are unnecessary, and the selection of antibiotics and duration of treatment are also often inappropriate. Evidence shows that antibiotic prescribing is influenced by psychosocial factors, including lack of accountability (...) , perceived patient expectations, clinician workload, and habit. A varied and growing body of evidence, including meta-analyses and randomized controlled trials, has evaluated interventions to optimize the use of antibiotics. Interventions informed by behavioral science-such as communication skills training, audit and feedback with peer comparison, public commitment posters, and accountable justification-have been associated with improved antibiotic prescribing. In addition, delayed prescribing, active
A review of antibiotic prophylaxis for travelerâ€™s diarrhea: past to present 30455974 2018 12 07 2055-0936 4 2018 Tropical diseases, travel medicine and vaccines Trop Dis Travel Med Vaccines A review of antibiotic prophylaxis for traveler's diarrhea: past to present. 14 10.1186/s40794-018-0074-4 As there is rapid increase in international travel to tropical and subtropical countries, there will likely be more people exposed to diarrheal pathogens in these moderate to high risk areas (...) and subsequent increased concern for traveler's diarrhea. The disease may appear as a mild clinical syndrome, yet a more debilitating presentation can lead to itinerary changes and hospitalization. As bacterial etiologies are the most common causative agents of TD, the use of antibiotic prophylaxis to prevent TD has been reported among travelers for several years. The most common type of antibiotic used for TD has changed over 50 years, depending on many influencing factors. The use of antibiotic prophylaxis
Hospital-based antibiotic use in patients with Mycobacterium avium complex 30402451 2018 11 14 2312-0541 4 4 2018 Oct ERJ open research ERJ Open Res Hospital-based antibiotic use in patients with Mycobacterium avium complex. 00109-2018 10.1183/23120541.00109-2018 Treatment guidelines exist for pulmonary Mycobacterium avium complex (MAC) infection, although studies suggest poor concordance in clinician practice. Using a national database including hospital encounters of laboratory-confirmed MAC (...) likely to be associated with receiving resistance-promoting regimens. In hospital-based MAC patients, half received antibiotics active against MAC, a low proportion received therapy based on MAC guidelines and many received antibiotics that promote macrolide resistance. Improved implementation of guidelines-based treatment is needed to decrease use of regimens associated with macrolide resistance. Ricotta Emily E EE Epidemiology Unit, Division of Intramural Research, National Institute of Allergy
The Hidden Cost of Commercial Antibiotic-Loaded Bone Cement: A Systematic Review of Clinical Results and Cost Implications Following Total Knee Arthroplasty 30217400 2018 09 15 1532-8406 2018 Aug 13 The Journal of arthroplasty J Arthroplasty The Hidden Cost of Commercial Antibiotic-Loaded Bone Cement: A Systematic Review of Clinical Results and Cost Implications Following Total Knee Arthroplasty. S0883-5403(18)30681-8 10.1016/j.arth.2018.08.009 The purpose of this systematic review (...) is to compare deep prosthetic joint infections (PJIs) between total knee arthroplasty (TKA) patients treated with either antibiotic-loaded bone cement (ALBC) or plain bone cement, and to explore the potential cost implications of commonly used bone cement regimens. We hypothesized that ALBC would not substantially reduce PJIs and would thereby present an unnecessary cost to the healthcare system. Using the PRISMA guidelines, we reviewed articles through May 2017 involving primary TKA patients with both ALBC
Inhaled antibiotics for pulmonary exacerbations in cystic fibrosis. BACKGROUND: Cystic fibrosis is a genetic disorder in which abnormal mucus in the lungs is associated with susceptibility to persistent infection. Pulmonary exacerbations are when symptoms of infection become more severe. Antibiotics are an essential part of treatment for exacerbations and inhaled antibiotics may be used alone or in conjunction with oral antibiotics for milder exacerbations or with intravenous antibiotics (...) for more severe infections. Inhaled antibiotics do not cause the same adverse effects as intravenous antibiotics and may prove an alternative in people with poor access to their veins. This is an update of a previously published review. OBJECTIVES: To determine if treatment of pulmonary exacerbations with inhaled antibiotics in people with cystic fibrosis improves their quality of life, reduces time off school or work and improves their long-term survival. SEARCH METHODS: We searched the Cochrane
Prophylactic antibiotic therapy for chronic obstructive pulmonary disease (COPD). BACKGROUND: There has been renewal of interest in the use of prophylactic antibiotics to reduce the frequency of exacerbations and improve quality of life in chronic obstructive pulmonary disease (COPD). OBJECTIVES: To determine whether or not regular (continuous, intermittent or pulsed) treatment of COPD patients with prophylactic antibiotics reduces exacerbations or affects quality of life. SEARCH METHODS: We (...) searched the Cochrane Airways Group Trials Register and bibliographies of relevant studies. The latest literature search was performed on 27 July 2018. SELECTION CRITERIA: Randomised controlled trials (RCTs) that compared prophylactic antibiotics with placebo in patients with COPD. DATA COLLECTION AND ANALYSIS: We used the standard Cochrane methods. Two independent review authors selected studies for inclusion, extracted data, and assessed risk of bias. We resolved discrepancies by involving a third
Antibiotics for exacerbations of chronic obstructive pulmonary disease. BACKGROUND: Many patients with an exacerbation of chronic obstructive pulmonary disease (COPD) are treated with antibiotics. However, the value of antibiotics remains uncertain, as systematic reviews and clinical trials have shown conflicting results. OBJECTIVES: To assess effects of antibiotics on treatment failure as observed between seven days and one month after treatment initiation (primary outcome) for management (...) antibiotic therapy and placebo and providing follow-up of at least seven days. DATA COLLECTION AND ANALYSIS: Two review authors independently screened references and extracted data from trial reports. We kept the three groups of outpatients, inpatients, and patients admitted to the intensive care unit (ICU) separate for benefit outcomes and mortality because we considered them to be clinically too different to be summarised as a single group. We considered outpatients to have a mild to moderate
Preventive antibiotics for gallbladder surgery not required in those at low or moderate risk Signal - Preventive antibiotics for gallbladder surgery not required in those at low or moderate risk Dissemination Centre Discover Portal NIHR DC Discover Preventive antibiotics for gallbladder surgery not required in those at low or moderate risk Published on 4 December 2015 Guidelines recommend that antibiotics are only prescribed before gallbladder keyhole surgery (laparoscopy) to those at increased (...) risk of infection. However, 36% of surgeons still prescribe them. This systematic review found that antibiotics given before removing the gall bladder by keyhole surgery for gallstone colic did not reduce the rate of surgical site infection, distant site infections or hospital-acquired infections. Though adverse effects due to the antibiotics were uncommon, inappropriate use adds to the growing problem of antimicrobial resistance. The review findings support NICE and the Royal College of Surgeon
Decontamination Strategies and Bloodstream Infections With Antibiotic-Resistant Microorganisms in Ventilated Patients: A Randomized Clinical Trial. Importance: The effects of chlorhexidine (CHX) mouthwash, selective oropharyngeal decontamination (SOD), and selective digestive tract decontamination (SDD) on patient outcomes in ICUs with moderate to high levels of antibiotic resistance are unknown. Objective: To determine associations between CHX 2%, SOD, and SDD and the occurrence of ICU (...) -acquired bloodstream infections with multidrug-resistant gram-negative bacteria (MDRGNB) and 28-day mortality in ICUs with moderate to high levels of antibiotic resistance. Design, Setting, and Participants: Randomized trial conducted from December 1, 2013, to May 31, 2017, in 13 European ICUs where at least 5% of bloodstream infections are caused by extended-spectrum β-lactamase-producing Enterobacteriaceae. Patients with anticipated mechanical ventilation of more than 24 hours were eligible
New evidence available on corticosteroids added to antibiotics in severe pneumonia Signal - New evidence available on corticosteroids added to antibiotics in severe pneumonia Dissemination Centre Discover Portal NIHR DC Discover New evidence available on corticosteroids added to antibiotics in severe pneumonia Published on 9 November 2015 For adults admitted to hospital with severe pneumonia, this review found that adding corticosteroids to the usual antibiotic treatment may be beneficial (...) in terms of treatment costs and loss of life: between 22 and 42% of adults with community acquired pneumonia are admitted to hospital and 5 to 14% of people with more severe illness die from the condition. Antibiotics are the main treatment for pneumonia. A 2011 systematic review of six small trials found that adding corticosteroid treatment increased speed of recovery slightly, but the evidence was not strong. The current review aimed to update the evidence on benefits and potential side effects
Isolation and genomic characterization of six endophytic bacteria isolated from Saccharum sp (sugarcane): Insights into antibiotic, secondary metabolite and quorum sensing metabolism 30310525 2018 11 14 1839-9940 6 2018 Journal of genomics J Genomics Isolation and genomic characterization of six endophytic bacteria isolated from Saccharum sp (sugarcane): Insights into antibiotic, secondary metabolite and quorum sensing metabolism. 117-121 10.7150/jgen.28335 Six endophytic bacteria were isolated (...) from Saccharum sp (sugarcane) grown in the parish of Westmoreland on the island of Jamaica located in the West Indies. Whole genome sequence and annotation of the six bacteria show that three were from the genus Pseudomonas and the other three were from the genera Pantoea , Pseudocitrobacter , and Enterobacter . A scan of each genome using the antibiotics and secondary metabolite analysis shell (antiSMASH4.0) webserver showed evidence that the bacteria were able to produce a variety of secondary
Systemic antibiotics for symptomatic apical periodontitis and acute apical abscess in adults. BACKGROUND: Dental pain can have a detrimental effect on quality of life. Symptomatic apical periodontitis and acute apical abscess are common causes of dental pain and arise from an inflamed or necrotic dental pulp, or infection of the pulpless root canal system. Clinical guidelines recommend that the first-line treatment for teeth with these conditions should be removal of the source of inflammation (...) or infection by local, operative measures, and that systemic antibiotics are currently only recommended for situations where there is evidence of spreading infection (cellulitis, lymph node involvement, diffuse swelling) or systemic involvement (fever, malaise). Despite this, there is evidence that dentists frequently prescribe antibiotics in the absence of these signs. There is concern that this could contribute to the development of antibiotic-resistant bacterial colonies within both the individual